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Health Care-plank-Ruwart
How To Make Health Care Affordable The Rising Cost of Health Care In our lifetimes, we’ve seen incredible advances in the quality of health care and even more incredible increases in the cost of that care. From 1970 to 2004, health-care spending nearly doubled as a percentage of Gross Domestic Product. Americans now spend about one of every six dollars they earn on health care. The Dangers of Universal Health Care Health care has now become unaffordable for the average American. Those who cannot afford health insurance are desperately seeking alternatives. Universal health care, more accurately called socialized medicine, has been touted as the solution. However, whenever government provides a service, its cost doubles. We pay that cost, either through taxes or inflation, when the government expands the money supply (prints more money) to cover it. Instead of solving the problem, socialized medicine will only increase the cost of health care further. Countries that have adopted socialized medicine are now turning to the marketplace for solutions. The only way that socialized medicine can keep from collapsing is to ration care, denying it to some and making others wait in lines so long that people literally die before getting the care that they so desperately need. In Britain, kidney dialysis is routinely denied to seniors on the grounds that the resources might serve society better by keeping them for the young. Canadians flood our northern states in order to get the cardiac bypasses and hip replacements that they need without having to suffer through a two-year queue. Of course, only the well to do have this option; the poor literally die waiting for the care they have been promised. Clearly, socialized medicine is not the answer. What is? The Root of the Problem Most goods and services come down in price as they improve in quality. Why does the cost of medical care continue to increase even as it becomes cheaper to manufacture the drugs we take and the microchips that power our marvelous new diagnostic computers? The answer is simple, but hidden from most of the American public. Only insiders like myself are aware of what is really happening. Government has increased the cost of medical care through excessive regulations -- regulations that harm rather than protect. One example that stands out in the pharmaceutical industry is the 1962 Kefauver Harris amendments to the Food and Drug Act. These regulations were enacted to protect the American public, but have caused irreparable harm in terms of both money and lives. The High Cost of Regulation About 80% of the cost of new pharmaceuticals is due to these regulations (for details, see my paper "Deadly Secrets Behind Soaring Pharmaceutical Prices"). Because these regulations allow the FDA to continuously increase the requirements for new drug development, the time to take a product from the laboratory bench to the marketplace has tripled since 1962 from 4.5 years to 15 years. Almost 5 million people have died prematurely since 1962 because of the additional 10-year wait in getting lifesaving drugs onto the pharmacy shelves. When I worked in AIDS research, my company discovered that by the time the FDA gave us permission to test our new drugs in people, every AIDS patient in the country who wanted to try them already had. Rather than die waiting, the AIDS community had hired black-market chemist to manufacture the potentially life-saving drugs and had distributed them to virtually every AIDS sufferer who wanted them. Neither the FDA nor the drug manufacturers chose to prosecute. Had they done so, the regulations would have been exposed for the cruel hoax that they are. However, cancer victims sued the government, claiming it was the constitutional right of dying patients to buy new drugs prior to FDA approval. The courts denied their claim, and the Supreme Court refused to hear the case (http://en.wikipedia.org/wiki/Abigail_Alliance_v._von_Eschenbach). Even if you are dying you need the FDA’s permission to try to save your life! You no longer own or control your own life; bureaucrats decide whether you live or die. At least 50% of innovative new drugs never even make it to the marketplace at all. The development costs are so high that very few drugs are still profitable. Since the pharmaceutical firms would perish if they couldn’t recover their costs, drugs that might save lives are never developed. You and your loved ones may die prematurely from a disease that has a treatment, but which can’t be marketed because the regulations make the cost prohibitive. The delay in getting new drugs to market and the loss of innovation contributes greatly to the overall cost of health care. For example, before the anti-ulcer drug Tagamet® came to market, the treatment for ulcers was surgery at a cost of about $25,000 plus lost work and leisure time. Tagamet® was considered an expensive drug; the average patient spent about $2000 for two courses of treatment, but did not have to lose any work or leisure time. Health-care costs for ulcer disease were slashed over 90% by switching patients from surgical treatment to drug therapy. Can you imagine how inexpensive our health care would be today if we hadn’t lost over 50% of our new innovations? The Shift from Prevention to Treatment- based Medicine As costly as the 1962 regulations are, both in money and in lives, by far the greatest damage that they have done is to switch us from a system of preventative care to treatment-based medicine. The old saying that “an ounce of prevention is worth a pound of cure” is almost certainly an understatement in the medical world. Part of the 1962 regulations empowered the FDA to deny approval to drugs that didn’t show substantial evidence of effectiveness. While this sounds reasonable on the surface, the “evidence” that the FDA now requires is so expensive to acquire that unpatented substances, like vitamins and minerals, can’t be put through the process. Consequently, the manufacturers can’t advertise their benefits easily. As a result, when the B vitamin folic acid was found to prevent serious birth defects, women and their physicians, were unaware of this inexpensive way to prevent a very costly and devastating medical condition. Even when the Center for Disease Control (CDC), another government agency, started asking women of childbearing age to take folic acid as a preventative, the FDA refused to let folic acid manufacturers even refer to the CDC’s recommendation. Consequently, this crucial information was not widely conveyed to the American public for over 10 years after it became available. It’s difficult to accurately estimate how many babies were aborted, or born and institutionalized, as a result of the FDA’s edict, but it almost certainly was in excess of 25,000. The FDA itself can certainly not be considered safe and effective even though it demands excessive evidence that pharmaceuticals, nutrients, and minerals meet that standard. This story is not unique. Many serious medical conditions, cancer and heart disease among them, can be improved if not completely prevented by proper nutrition. Yet medical schools, whose curricula is determined by the licensing boards, rarely require even one full course of nutrition in their entire four-year program. Imagine how much lower health care costs would be if we were allowed to utilize all of our medical knowledge rather than limit ourselves to knowledge that is “politically correct.” Regulation of Health Care Providers Progress, or loss of progress, in the pharmaceutical industry can be traced to fairly discrete changes in regulatory law. The medical profession, which determines what types of treatment can be practiced, are largely controlled by the American Medical Association’s representatives on state licensing boards. However, regulations governing hospitals and some forms of medical practice are much more convoluted. All regulations have one thing in common: They take freedom of choice away from the patient and put it into the hands of bureaucrats who suffer no consequences if their choices result in hundreds, thousands, or even millions of premature deaths. Certification Instead of Regulation Freedom of choice must be returned to the individual. The only way to do that is to replace regulation with certification. The electrical industry has already proven that certification increases quality and lowers costs. Most of the appliances in your home probably have a “UL-listed” symbol on them, certifying that they have been tested for safety by an independent laboratory that is funded by electrical manufacturers’ liability insurance carriers. UL has a vested interest in making sure that our electrical product is safe because its certification will mean little if the products that carry the UL “Seal of Approval” turn out to be defective. Before pharmaceuticals required FDA approval, certifying organizations like the American Medical Association and Consumers’ Research provided physicians with an independent evaluation of each drug’s side effects and benefits. Physicians and patients who wanted to “play it safe” waited until new pharmaceuticals were certified. However, in a life-threatening situation, or other compelling circumstances, these products were available to consumers, who did not need to wait for a bureaucrat to make a life and death decision for them (for more detail on how such a system might work, see my book, Healing Our World edition, Chapters 5 and 6). New drugs were affordable since manufacturers had fewer regulatory hoops to jump through. Real Tort Reform Is Mandatory With health care costs so high, more and more people feel entitled to compensation for any medical problem that arises, even if the healthcare provider is not directly responsible. The number of obstetrics and gynecology practitioners has dwindled rapidly as parents increasingly sue their physicians if their child is born with a medical problem, whether the doctor is responsible or not. Libertarians believe that those who harm innocents need to compensate their victims. However, if the problem is an act of nature or of God, physicians and their insurers should not be held liable. Many people believe that going after a profitable insurance company is like winning the lottery. Settlements based not on culpability, but on the desire to put one’s hand in “deep pockets,” increase the cost of physician liability insurance. The physicians pass these costs on to other patients in the form of higher fees. When damages are based on negligence and/or physician culpability, settlements will be more appropriate. Those who have been harmed by their health care provider will still be compensated. Physician liability insurance will remain reasonable rather than adding greatly to the costs of medical care today. Getting Government Out of Insurance Once government moved into the insurance business with Medicare, Medicaid, and special legislative protections for HMOs, the use of insurance begin to shift. When government provides medical insurance to the elderly or poor with a low fixed premium, those receiving it are going to make maximum use of it. They’ll go to the emergency room for problems that really only call for doctor appointments. They’ll want tests that they wouldn’t have had if the cost came out of their own pockets. In other words, they will create extra demand for healthcare. When demand goes up, prices do too. Over time we’ve come to expect insurance to pay most or all of our medical bills. Unfortunately, processing small claims often costs more than the claims themselves. In addition, the cost of medical insurance has risen not only because of increased medical costs, but because so many features of insurance are mandated by state governments. Instead of buying the insurance package that fits each of our individual needs, we are often forced to buy one that is much more comprehensive -- and costly -- than we would like, simply because state regulations demand it. The Bottom Line Health care is unaffordable primarily due to mountains of regulatory red tape that do little to protect us and much to harm us. Doing away with the root cause of soaring health care costs -- government interference in medicine -- is the only thing that will lower costs both in terms of lives and money. Anything else is simply putting Band-Aids on a gushing hemorrhage: ineffective at best and deadly at worst. :“Healing Our World bridges the gap between conservatives and liberals, Christians and New Agers, special interests and the common good, with practical solutions to our economic and societal woes.” - Ron Paul, MD, U.S. Congressman Links * Mary Ruwart Category:Planks from elsewhere